VANCOUVER — Canada's attorney general and minister of health have lost their appeal of a court ruling on Vancouver's controversial supervised injection site, raising proponents' hopes that similar facilities will now open in other cities.The B.C. Appeal Court decision Friday upheld a lower court ruling that provinces, not the federal government, have jurisdiction for health care, and therefore services such as the injection site.

Dr. Julio Montaner, director of the B.C. Centre for Excellence in HIV-AIDS, said the decision sends a clear message that Prime Minister Stephen Harper should abandon "his draconian, ideologically motivated public health policy-making" and embrace evidence-based research to continue operating the clinic, called Insite.

Montaner said he's had discussions with officials in Montreal, Toronto, Victoria and San Francisco about those cities having their own clinics modelled after Insite.

"There is tremendous interest in a number of cities around the world based on the fact that not only have we piloted this initiative but the supervised injection site is the best studied in the world," he said.

Chief Justice Lance Finch walked into an overflowing courtroom for the announcement. About 50 supporters of the clinic applauded after he finished reading the ruling.

"It's a clean sweep," said lawyer Joe Arvay, who represented the Portland Hotel Society, which runs Insite, and helped launch the original court action against the federal government.

"Let's just say that one hopes that they (the government) will accept the decision of the court, which is obviously very well thought out and considered."

Monique Pongracic-Speier, another lawyer for the society, said the judgment focuses on a lower court's decision that the provinces, not the federal government, are responsible for delivering health care.

"The court has given very cogent reasons for why (Insite) is not only an essential service to drug users but one that is within the provincial government's purview," Pongracic-Speier said of North America's only such facility.

"The province has to be able to make decisions about how to deliver health care to some of the most vulnerable people in the Downtown Eastside."

Drug users bring their own drugs to the clinic, where they can inject them under the supervision of a nurse. It opened in 2003 as part of a harm-reduction plan to tackle an epidemic of HIV-AIDS and drug overdose deaths.

Montaner said that since the facility opened, there's been a 30 per cent increase in the number of addicts who enter detox.

David Thomas, spokesman for Health Canada, said in an email response to a request for an interview that the government is reviewing the decision carefully. "While the Government respects the court's decision, it is disappointed with the outcome," Thomas wrote.

Insite supporters initially launched the court action out of fear that the Conservative government would not renew the exemption when it expired at the end of June 2008.

The earlier B.C. Supreme Court decision struck down parts of Canada's drug laws, finding that the Controlled Drugs and Substances Act was not in line with the Charter of Rights and Freedoms.The lower court ruling found that Insite is a health care facility, and therefore provincial jurisdiction, not federal, and gave Insite immediate constitutional exemption to stay open without a federal exemption from drug laws.

Federal lawyers argued that the government is under no obligation to make it easier for citizens to break the law by condoning a supervised injection site.

Dean Wilson, one of two original plaintiffs in the case, said outside the court that the victory makes it clear that Insite provides a "common-sense approach" to those battling drug addiction."It's working, it's working, that's all I can say," said Wilson, who was the first person to use Insite, which he regards as a critical harm-reduction facility that protects people's health.

"Now other provinces can use this as case law and do their thing," said Wilson, who said he's also used Insite's detox facility, called Onsite, and lived in transitional housing.

Supporters of Insite placed four large posters outside the court Friday, with photos of babies and young children on bicycles and rocking horses over captions that read: "Before they were junkies they were kids. Support Insite."

The federal government could appeal the decision to the Supreme Court of Canada, but Arvay said the Conservatives would be wasting more money by doing so.

"Why waste taxpayers with an appeal, especially when that money could be used to help the most vulnerable people in the city, in the Downtown Eastside?" he said.

The appeal court ruled that the federal government must pay the court costs for those who have fought to keep the facility open since it began operating.